Factors Affecting the Outcome of Frontalis Sling Surgery in Patients with Severe Blepharoptosis

BACKGROUND: Several factors play a role in the outcome of severe blepharoptosis correction by frontalis sling surgery, including the age of a patient, sex, causes of ptosis, and its severity, among others. Identifying the factors that most severely affect surgical outcomes could reduce the complication rate and improve patients’ satisfaction. METHODS: This was a retrospective analytical study using logistic regression statistics to evaluate the effects of the following 6 factors on frontalis sling surgical outcomes: age, sex, cause of ptosis, type of anesthesia used, eye side (right or left), degree of ptosis, and levator function. These factors were compared with 10 types of surgical outcomes. The study included 120 eyelids in 95 patients, of which 70 eyelids were unilateral and 50 eyelids were bilateral. Patient ages ranged between 2 and 75; patient sex distribution was 47.5% females and 52.5% males. RESULTS: The study yielded 60 comparison tables. Only statistically significant and clinically relevant data are presented and discussed. Overall, male patients showed better eye symmetry (P < 0.026) and better satisfaction (P < 0.004) than did females. Causes other than the congenital ptosis are characterized by better eye closure during sleep (P = 0), in comparison with congenital ptosis cases. CONCLUSION: The use of silk suture as a sling material is recommended for male patients, as its use produces better results, including eye symmetry and patient satisfaction, with a lower complication rate compared with that in female patients.